Staff training, local referrals, and other processes need to be in place before implementing refugee mental health screening. Continue the dialogue from the RHTAC May 23, 2012 webinar, Refugee Mental Health Screening: Operationalizing the RHS-15, presented by Beth Farmer, MSW and Sasha Verbillis-Kolp, MSW.
What are the biggest barriers to offering mental health services to refugees in your community? What would it take to overcome those barriers? What strengths currently exist in your community that you can leverage? Leave your comments below.
I would like to share the positive experience we’ve had in addressing Refugee Mental Health within Catholic Charities Fort Worth. It is now more than two years after we started a new program “refugee mental health and cultural adjustment”. As Tsegaba stated, one of the great tool, I used in reaching out in refugees’ communities and dissipate the stigma, was community leaders. I hired “natural leaders” , trusted people in their communities to run community support groups. Those “cultural ambassadors” run groups in their languages, at the apartment complex. I know how difficult it can be to discuss mental health in refugees’ communities, but our program does initiate that conversation at the begining. We begin by other interesting topics, such as parenting and family dynamic, nutrition, story telling, re-connect…all these modules lead us to open mental health topics, which I teach at the groups. I’ve found very successful that model of not introducing mental health at the begining, instead, starting with common issues and get to MH slowly. Our program has now a huge impact in refugee communities. Refugees are now open for counseling, medications…All depends on how we approach the issue.
One of the largest barriers I have noticed as we begin to roll out our MH Screening and Referral process here in SLC, UT is the pervasive stigma around mental health both within the refugee client populations and within the resettlement agency staff (many of whom are former refugees). This means that even when we successfully identify clients that may benefit from MH services agency staff may not yet feel comfortable initiating this discussion with their clients. We are working to create mental health coordinator positions within the two local resettlement agencies to help facilitate these discussions and referrals. Additional training that can lower the stigma around these issues will be useful.
Thank you for your comment. The stigma can definitely be a barrier to connecting those in need to support. As the outreach coordinator for the pathways project, a lot of my role was involved in reaching out to the refugee communties and develop culturally sensitive ways to talk about mental health so that stigma can be reduced, including trainings. The community leaders play such a critical role in helping to reduce the stigma and increase access to services to those in need. If there’s any way for you or your agency to get connected and ally with the community leaders who already have the trust of the community I think it would make a big difference. Through community leaders our project was able to get connected to the community and provide trainings about what mental health means in the U.S.; normalizing their experiences. Every state and county is different so I’m not sure how much access you would be able to have to community leaders. It can be difficult however when there is stigma within community leaders as well including the resettlement staff you were referring to. I would say education plays a key role in reducing the stigma. If the community leaders can be educated about what mental health really means and how it affects refugee populations, perhaps the stigma might be reduced a little, and at least will allow folks to feel comfortable to enter services. Thank you for all your great work.
Thank you for the presentation!! We have a lot of work ahead of us in terms of developing culturally competent tools and services to refugees. We need to 1) encourage providers/systems to use tools such as RHS-15, 2) encourage mh providers to accepts referrals, 3) develop skills and competencies to work with refugees, 4) train mental health interpreters , and 5) financial incentives for the providers to provide services to refugees.
Thanks so much for all the hard work on these challenging topics! Interpretation seems to be the biggest barrier– concerns over using interpreters from the clients’ communities, effectiveness of interpretation, getting interpreters adequately trained for the mental health setting, finding providers who are comfortable working with interpreters. We’re in the planning process for providing an in-depth mental health interpretation training, which should help address some of these issues.We are very lucky in Baltimore to have a partnership with the Community Psychiatry Program at Johns Hopkins Bayview and the resettlement service providers– those partnerships are definitely a huge strength in our community!
Thanks for the informative webinar. One of our challenges: We find that the relationship building needed requires more than the 45-50 minutes we can bill for and isn’t satisfying for the client or clinician – How are other communities addressing this time crunch?
For those of you interested in adopting the RHS-15, we prepared two suggested scripts for your use. One is on how you introduce the screening during your initial visit and the other is on how to offer support for referral. thanks-Sasha